Subject(s)
Angiogenesis Inhibitors , Diabetic Retinopathy , Intravitreal Injections , Macular Edema , Ranibizumab , Receptors, Vascular Endothelial Growth Factor , Recombinant Fusion Proteins , Visual Acuity , Humans , Receptors, Vascular Endothelial Growth Factor/administration & dosage , Receptors, Vascular Endothelial Growth Factor/therapeutic use , Ranibizumab/administration & dosage , Diabetic Retinopathy/drug therapy , Diabetic Retinopathy/diagnosis , Macular Edema/drug therapy , Macular Edema/diagnosis , Recombinant Fusion Proteins/administration & dosage , Recombinant Fusion Proteins/therapeutic use , Angiogenesis Inhibitors/administration & dosage , Angiogenesis Inhibitors/therapeutic use , Male , Female , Tomography, Optical Coherence/methods , Vascular Endothelial Growth Factor A/antagonists & inhibitors , Retrospective Studies , Aged , Middle Aged , Treatment OutcomeSubject(s)
Angiogenesis Inhibitors/administration & dosage , Diabetic Retinopathy/drug therapy , Macular Edema/drug therapy , Ranibizumab/administration & dosage , Receptors, Vascular Endothelial Growth Factor/administration & dosage , Recombinant Fusion Proteins/administration & dosage , Visual Acuity/physiology , Aged , Diabetic Retinopathy/diagnostic imaging , Diabetic Retinopathy/physiopathology , Female , Humans , Intravitreal Injections , Macular Edema/diagnostic imaging , Macular Edema/physiopathology , Male , Middle Aged , Retrospective Studies , Tomography, Optical Coherence , Vascular Endothelial Growth Factor A/antagonists & inhibitorsABSTRACT
Novel treatment strategies such as targeted therapy with mitogen-activated protein-kinase-kinase/B-Raf proto-oncogene (MEK/BRAF) inhibitors have prolonged patient survival in metastatic melanoma and are used in oncology. The combination of binimetinib og encorafenib can induce extensive bilateral neuroretinal detachments. In this case report, we present a 72-year-old female patient with this condition. Dilated fundus examination and optical coherence tomography are essential in diagnosis and monitoring of patients treated with MEK/BRAF-inhibitors. No persistent visual deficits were documented in the patient, as this condition appears to be fully reversible.
Subject(s)
Melanoma , Retinal Diseases , Aged , Antineoplastic Combined Chemotherapy Protocols , Benzimidazoles/therapeutic use , Female , Humans , Melanoma/drug therapy , Mutation , Protein Kinase Inhibitors/adverse effects , Proto-Oncogene Mas , Proto-Oncogene Proteins B-raf/genetics , Retinal Diseases/chemically inducedABSTRACT
BACKGROUND: Combination antiretroviral therapy (cART) has drastically increased the life expectancy of HIV-infected patients. However, HIV-infected patients exhibit increased inflammation and 33-58% exhibit a characteristic fat re-distribution termed HIV-associated lipodystrophy syndrome (HALS). Recombinant human growth hormone (rhGH) has been tested as treatment of HALS. Low-dose rhGH therapy improves thymopoiesis and fat distribution in HIV-infected patients and appears to be well tolerated. However, since high-dose rhGH is associated with adverse events related to inflammation, we wanted to investigate the impact of low-dose rhGH therapy on inflammation in HIV-infected patients. METHODS: Forty-six cART-treated HIV-infected men were included in the HIV-GH low-dose (HIGH/Low) study: a randomized, placebo-controlled, double-blinded trial. Subjects were randomized 3:2 to 0.7 mg/day rhGH, or placebo for 40 weeks. rhGH was self-administered between 1 pm and 3 pm. The primary outcome of this substudy was changes in inflammation measured by plasma C-reactive protein (CRP) and soluble urokinase plasminogen activator receptor (suPAR). RESULTS: Both CRP (-66%, p = 0.002) and suPAR (-9.7%, p = 0.06) decreased in the rhGH group compared to placebo; however, only CRP decreased significantly. The effect of rhGH on inflammation was not mediated through rhGH-induced changes in insulin-like growth factor 1, body composition, or immune parameters. CONCLUSION: Daily 0.7 mg rhGH treatment for 40 weeks, administered at nadir endogenous GH secretion, significantly reduced CRP. The effect does not appear to be mediated by other factors. Our findings suggest that low-dose rhGH treatment may minimize long-term risks associated with high-dose rhGH therapy.
